Inside Health

VITAL SIGNS: VISION; A Prescription for Patient Error

By ERIC NAGOURNEY

Published: November 23, 2004

For people with vision problems, a new study suggests, that is a typical experience as they struggle to read the tiny type crammed onto prescription labels.

''Although medical information is often communicated in writing,'' the researchers write in the current issue of The British Journal of Ophthalmology, ''little attention is given as to whether patients can read it. This is particularly true for instructions on eyedrop bottles prescribed to the visually impaired.''

The researchers, led by Dr. Suzannah Drummond of Gartnavel General Hospital in Glasgow, Scotland, asked 180 patients with varying degrees of vision problems to read the instructions on the side of an eyedrop medicine box. The patients could not use a magnifying lens, but they could bring the box as close to their faces as they wanted ''because this is what would happen at home,'' the study said.

The researchers recorded whether the volunteers were able to read the instructions and, if so, how much trouble they had. They also showed the patients labels with different sizes of type and asked which they preferred.

The study found that patients with vision of 20/60 or better could generally read the labels. People with that level of vision can read at 20 feet what people with unimpaired vision can read at 60 feet, Dr. Drummond said. People with worse vision generally could not.

The study recommended that patients with vision worse than 20/60 be given medical instructions in 22-point type. (The type on this page is just under nine points.)

The advice holds true for all medications, not just eyedrops, Dr. Drummond said. And though in some cases instructions will fit only on inserts, she predicted no resistance from drug companies.

For the drug and therapeutics industry, which are constantly looking for ways to improve patient compliance, she said in an e-mail message, ''this relatively simple measure would seem an obvious choice in an increasingly elderly and partially sighted population.''